HomeMy WebLinkAboutPermit Mechanical 2013-12-16 SPRINGFIELD i 225 Fifth St
t �^- CITY OF SPRINGFIELD Springfield,OR 97477
L.41 Phone: 541-726-3753
,:4••• OREGON Building I Commercial Permit Inspection Phone: 541-726-3769
Fax: 541-726-3676
PERMIT NO: 811-SPR2013-02666
www.springfield-or.gov permitcenter@springfield-or.gov
PROJECT STATUS: Issued • ISSUED: 12/16/2013 EXPIRES: 06/14/2014
STATUS DATE: 12/16/2013 APPLIED: 12/12/2013
SITE ADDRESS: 2600 MAIN ST,Springfield,OR 97477 SCOPE: Mechanical Only
ASSESOR'S PARCEL NO: 1703364100701 TYPE OF STRUCTURE: Commercial
PROJECT DESCRIPTION: Re Hang unit heater • ,
OWNER: KRYLS INVESTMENTS INC Phone Number:
ADDRESS: 3474 SPRING BLVD
EUGENE OR 97405
CONTRACTOR INFORMATION
Il
Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone
KENT M WITHAM (LEB)Electrician.i 1178LEB 10/01/2014 541-689-2044
L INSPECTIONS REQUIRED
Inspections
2999 Final Mechanical Final Mechanical: When all mechanical work is complete.
By signature, I state and agree,that I have carefully examined the completed application and do hereby certify that all
information hereon is true and correct, and I further certify that any and all work performed shall be done in accordance with the
Ordinances of the City of Springfield and the Laws of the State or Oregon pertaining to the work described herein, and that NO
OCCUPANCY will be made of any structure without permission of the Community Services Division, Building Safety. I further
certify that only contractors and employees who are in compliance with ORS 701.005 will be used on this project. I further agree
to ensure that all required inspections are requested at the proper time,that each address is readable from the street,that the
permit card is located at the front of the property, and the approved set of plans will remain on the site at all times during
construction.
:r/_ "— ' /a 76-13
Own- or Contra• or Signature Date
NOTICE:
ATTENTION: Oregon law requires you to THIS PERMIT SHALL EXPIRE IF THE WORK
follow rules adopted by the Oregon Utility AUTHORIZED UNDER THIS PERMIT IS NOT
Notification Center. Those rules are set forth COMMENCED OR IS ABANDONED FOR
in OAR 952-001-0010 through CAR 952-001-
0090. You may obtain copies of the rules by ANY 180 DAY PERIOD.
calling the center. (Note: the telephone
number for the Oregon Utility Notification
Center is 1-800-332-2344).
•
Springfield Building Permit 12/16/201 10:29:48AM Page 1 of 1
SPRINGFIELD CITY OF SPRINGFIELD
225 Fifth St
CaP OREGON TRANSACTION RECEIPT Springfiel&OR97477
541-726-3753
811-SPR2013-02666
www.springfield-or.gov 2600 MAIN ST permitcenter@springfield-or.gov
RECEIPT NO: 2013002669 RECORD NO: 811-SPR2013-02666 DATE: 12/16/2013
!DESCRIPTION _ • ,._AC000NTCODE/TRANS CODE_, __ AMOUNT DUE-
Mechanical Permit fee(based on value of work) 224-00000-425604 1006 80.00
State of Oregon Surcharge(12%of applicable fees) 821-00000-215004 1099 9.60
Technology fee(5%of permit total) 100-00000-425605 2099 4.00
�` _... TOTAL DUE: 93.60
r,- PAYMENT TYPE_ PAYOR CASHIER:JLARSON °-- = COMMENTS. AMOUNT PAID -. ' I
Check _ - _m KENT M WITHAM KENT M WITHAM 93.60
2419
TOTAL PAID: 93.60
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Mechanical Permit Application DEPARTMENT USE ONLY
SiliNGPIELD 577 O
CITY OF Sr.RWCFIELD, OREGON ', !' Permit no.:
mr-c .w..:., < r s �.E x-.a_. Pr • 3.i - Sic ) / !
225 Fifth Street •Springfield,OR 97477 • PH(541)726 3753 • FAX(541)726-3689 - DxEGON Date: �/ l Z/(
This permit is issued under OAR 918-440-0050. Permits expire if work is not started within 180 clays of issuance or if work is
suspended for 180 clays.
CATEGORY OF CONSTRUCTION FEE SCHEDULE
CI Residential ID Government ❑Commercial Residential Qty. Cost Total
ea. cost
JOB SITE INFORMATION AND LOCATION First Appliance $80.00 $
Joh site address:(149 M a/h s'I Furnace/burner including ducts and vents
City:SA--I Ng Pie e]d State: oR. ZIP: 97'f 77 Up to I0(1k lfI'lJ/hr. $18.50 S
Over 100k IS'I'UIhr. $22.00 5
Reference: Taxlot.:
Healers/stoves/vents
DESCRIPTION OF WORK Unit heater $18.50 $
R NQt0,4 oK* Reokter Wood/pellet/gas stove/flue $42.00 $
JJ Repair/alter/add to heating appliance/
refrigeration unit or cooling system/ $80.00 S
PROPERTY OWNER absorption system
Name: ?6-7-1'11 K11:1 (.....- Evaporated cooler $14.50 $
Vent fan with one duct/appliance vent $10.00 $
Address:
Hood with exhaust and duct $14.50 S
City: State: ZIP:
Floor furnace including vent $80.00 S
Phone: - - Fax: - - Gas piping
E-mail: One to four outlets $7.50 $
This installation is being made on property owned by me or a Additional outlets(each) $4.50 S
member of my immediate family, and is exempt from licensing Air-handling units, including ducts
requirements under ORS 701.010. Up to 10,000 CM $12.00 S
Signature: Over 10.000 CM $22.00 S
CONTRACTOR INSTALLATION Compressor/absorption system/heat pump
Keu�- o3itanv !�-ir- up to 3 hp/100k BTU $18.50 $
Business name: !n C
BOX (75& Up to 15 hp/SODA BTU $32.00 $
Address: U Up to 3011p/1.000 13 TO 547.50 $
City: 3/ ra Npr r l e/d State:CR -ZIP: 77977,, Up to 50 hp/1,750 BTU S62.50 $
Phone:5{1-,5T 6525t) FaxA -(>. - 5'924, Over 50 hp/1,73013ru $104.50 $
E-mail: Incinerators
_—_—_._.._.._......... Domestic incinci:ator 1 $22.50 I_.$
CCIS license no.: —__.. _ _..._...-...
Commercial
Print name: Enter total valuation of mec meal system
--- — and installation costs$ ---
Signature:
-- Enter fee based on valuation of-mechanical system,etc. J $
Miscellaneous fees Items Cost Total
ea, cost
Reinspection $80.00 $
Specially requested inspections(per hr.) $80.00 $
Regulated equipment(unclassed) $14.50 $
Each additional inspection:(I) $80.00 $
APPLICANT USE
(A)Enter subtotal of above fees(or enter set
minimum fee of $80.00) $
(13)Investigative lee(equal to[A]) $
(C)Enter 12%surcharge(.12 x[A+EI) $ (o_
(D)Seismic fee. I%(.01 x [Al) S �,�
(Ii)Technology Fee(5%of(A]) $ i /'n
440-2545-i(4!I/2013/COM) TOTAL fees and surcharges(A through E): $ i3